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Thursday, February 20, 2014

World Wide Shortage Of Yellow Fever Vaccine May Affect World Cup Fans

The unavailability of the vaccine can mean that travelers to countries that require YF vaccination may be denied entry. Travelers to YF endemic countries that do not require vaccination not only put themselves at risk, but if they visit other countries while viremic and are exposed to vector mosquitoes, they run the risk of starting a YF outbreak. There is concern about football (soccer) fans attending the FIFA World Cup games [12 Jun-13 Jul 2014] in those parts of Brazil where YF virus is endemic, such as the Manaus area. One hopes that the shortage will indeed end in March 2014, providing enough time for football fans and players to receive the vaccine if they act promptly when the vaccine becomes available.
Those planning to attend one or more of the World Cup venues or other YF endemic areas in South America, Darien, Panama, or Africa should determine whether they are in the YF risk areas.
As noted in WHO's yellow fever vaccination requirements and recommendations (http://www.who.int/ith/chapters/ith2012en_countrylist.pdf?ua=1), yellow fever vaccination is "recommended for all travelers 9 months of age or older going to the following areas: the entire states of Acre, Amapa, Amazonas, Distrito Federal (including the capital city of Brasilia), Goias, Maranhao, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Para, Rondonia, Roraima, Tocantins; and designated areas of the following states: Bahia, Parana, Piaui, Rio Grande do Sul, Santa Catarina, and Sao Paulo (state). Vaccination is also recommended for travelers visiting Iguazu Falls. [It is] not recommended for travelers whose itineraries are limited to areas not listed above, including the cities of Fortaleza, Recife, Rio de Janeiro, Salvador, and Sao Paulo."
[Although the WHO guidelines say that vaccination is not required for Rio de Janeiro and other coastal cities, most Brazilian cities including Rio are suffering from dengue epidemics, which mean they are infested with _Aedes aegypti_ mosquitoes, the same mosquitoes that transmit yellow fever. So if a football fan or other tourist (either Brazilian or international) goes into the Amazon jungle and gets yellow fever, he or she could bring it back to Rio
Brazil also considers that there is no risk of YF transmission in the coastal areas of the states of Piaui, Ceara, Rio Grande do Norte, Paraiba, Pernambuco, Alagoas, Sergipe, Bahia, Espirito Santo, Rio de Janeiro, Sao Paulo, Parana, Santa Catarina, and Rio Grande do Sul.
Doctors in Sheffield [South Yorkshire, England] are urging people travelling to Africa and South America to get protected against yellow fever -- after taking delivery of a rare batch of the jab during a worldwide shortage.

Sheffield Travel Clinic, based at the Royal Hallamshire Hospital, has received a consignment of the drug, which is expected to remain scarce until the end of next month [March 2014].

Yellow fever is transmitted by mosquitoes in Africa, South America, and some parts of the Caribbean. Symptoms include fever, severe headaches, back pain, body aches, nausea, vomiting, and fatigue. Some patients also enter a second, more toxic phase, when jaundice and kidney failure can occur.
Source proMED-mail

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